Mid-Year Benefit Changes

Size: px
Start display at page:

Download "Mid-Year Benefit Changes"

Transcription

1 Mid-Year Benefit Changes If you experience a change in your personal or work life that impacts your State Employee Health Plan (SEHP) benefit elections, KU Benefits is ready to help you navigate the change process. Please see the notes below to help you make Mid-Year changes to your benefit elections. All changes require you to enter your request into the Membership Administration Portal (MAP) within 30 calendar days from the date of family status change. Required documentation to request a Mid-Year Change: The following items are appropriate supporting documentation required to be uploaded into MAP with the Enrollment or Change Request when adding or removing eligible individuals. Listed below you will find the most common Mid-Year Changes. Additional Changes can be found in the State Administration Manual starting on page 37. Change in Family Status Type of Documentation Documentation to add person(s) to Insurance Marriage Marriage License Completed in English Spouse and stepchild Birth Birth certificate or hospital birth Newborn announcement in English Adoption Petition for adoption or placement agreement completed in English for dependent child Court order completed in English for dependents who are not biological or adopted children of the primary member Adopted Child(ren) Adoption of a Grandchild(ren) Divorce Continuation of Coverage for a Disabled Child(ren) Loss of Other Coverage Certificate of birth completed in English and Dependent Grandchild Affidavit for children born to a covered dependent (grandchild), along with copy of current years filed Federal tax return for proof of financial dependency and residency. First and last pages of the final divorce decree including court recorded date stamp and judge s signature An Application for Coverage of Permanent and Totally Disabled Dependent Child affidavit for covered dependent children aged 26 or older and copy of current years filed Federal tax return for proof of financial dependency and residency. A certificate of credible coverage stating that you have been removed from your previously occupied plan Grandchild(ren) Spouse, Child(ren) Disabled Child(ren) over age 26 Entire Family, Spouse, Child(ren) Death of a Dependent Death Certificate Spouse, Child(ren)

2 NOTE: In order to match documentation for a spouse or dependent(s) to the appropriate primary member, the documentation must be legible. Documentation is uploaded through the primary member s record in MAP. Uploading Documentation into MAP Scan the required documentation and login to MAP. After you enter your login information, scroll to the bottom of the Member and Family Tab. You will see the image below; select browse and upload all required documents.

3 After you have uploaded the required documentation, follow the steps below to complete your midyear status change: 1.) Click Mid-Year Benefit Changes Tab as indicated below: 2.) Then select start a New Request. 3.) Choose one of the four options listed below: a. Newly Eligible Dependent (Adoption, Birth, Marriage, Gained Custody) b. Add/Drop a Dependent due to a Change in Coverage (Marriage, Loss of other coverage) c. Death of Spouse or Dependent d. Remove Ineligible Dependent (Divorce)

4 Select the applicable option as listed below, enter in the date of the event and include any necessary notes. Then select the green Submit Request button to complete your enrollment. Premium Adjustment Once this request has been processed, the SEHP will send an update request to KU. Depending on the timing of this request, KU Benefits may need to request a Payroll adjustment based on when the coverage is effective which will result in a prorated premium adjustment or refund.

5 Premium Rates To verify premium rates, please visit 2018 Booklet (Rates are on pages 22-23): Updating Beneficiaries Visit Changes & Life Events page to access a beneficiary form to change your Basic or Optional Group Life Insurance beneficiary. After the form is completed please forward to the HR Benefits office by either fax or by campus mail to Human Resources Benefits. Need Help? KU Benefits is here to assist you. Hotline: to speak to a Benefits Specialist (Monday - Friday, 8:00 am - 5:00 pm CST) In Person: 150 Carruth-O'Leary, 8:00 a.m. to 5:00 p.m., M-F benefits@ku.edu

Benefits Handbook Date November 1, Dependent Children Life Insurance Plan MMC

Benefits Handbook Date November 1, Dependent Children Life Insurance Plan MMC Date November 1, 2010 Dependent Children Life Insurance Plan MMC Dependent Children Life Insurance Plan This plan is an employee-paid group term life insurance plan that helps you provide for your family

More information

Enrolling in Benefits for Graduate Assistants and Interns:

Enrolling in Benefits for Graduate Assistants and Interns: Enrolling in Benefits for Graduate Assistants and Interns: New Hire Overview This job aid will assist you with your new hire health and group life insurance benefits enrollment in Core-CT. You have up

More information

January 1, Dependent Children Life Insurance Plan MMC

January 1, Dependent Children Life Insurance Plan MMC January 1, 2009 Dependent Children Life Insurance Plan MMC Dependent Children Life Insurance Plan This plan is an employee-paid group term life insurance plan that helps you provide for your family s financial

More information

1. Welcome to BenefitBridge. To access the BenefitBridge portal, login to BenefitBridge from the internet. 2. In the internet address bar, type:

1. Welcome to BenefitBridge. To access the BenefitBridge portal, login to BenefitBridge from the internet. 2. In the internet address bar, type: 1. Welcome to BenefitBridge. To access the BenefitBridge portal, login to BenefitBridge from the internet. 2. In the internet address bar, type: www.benefitbridge.com/egusd 1 1. If you are a returning

More information

Enrolling in Benefits:

Enrolling in Benefits: Enrolling in Benefits: New Hire Overview This job aid will assist you with your new hire health and group life insurance benefits enrollment in Core-CT. You have up to 31 days following your date of hire

More information

Insurance Department Employee Benefits (Revised 05/01/2018) TCG Online Benefit Enrollment System:

Insurance Department Employee Benefits (Revised 05/01/2018) TCG Online Benefit Enrollment System: Insurance Department Employee Benefits (Revised 05/01/2018) If you have experience a qualified life event, you must make the change or enrollment on the TCG Online Benefit Enrollment System NO LATER THAN

More information

Health Plan. Coordinator. Handbook

Health Plan. Coordinator. Handbook Health Plan Coordinator Handbook 1 Welcome to Health Tradition Health Plan The Health Plan Coordinator Handbook is designed to help you deliver health benefits to employees. Please read the handbook carefully

More information

Dependent Verification PO Box IRVING, TX FAX:

Dependent Verification PO Box IRVING, TX FAX: Dependent Verification PO Box 165308 IRVING, TX 75016 9923 July 5, 2016 Enrollee Name Street Street2 City, St, Zip Dear NYSHIP enrollee, PC or Mobile Upload: www.verifyos.com FAX: 1 877 223 8478 Go green

More information

2019 State Employee Health Plan Open Enrollment

2019 State Employee Health Plan Open Enrollment 2019 State Employee Health Plan Open Enrollment Enrollment Questions What is Open Enrollment? Open Enrollment is the time of year in which plan elections can change and dependents can be added or removed

More information

Employee Enrollment User Guide

Employee Enrollment User Guide Employee Enrollment User Guide Welcome to Online Enrollment! In this guide, you will find information and step-by-step instructions on how to enroll in your benefits. Table of Contents Before you get started:

More information

1. Welcome to BenefitBridge. To access the BenefitBridge portal, login to BenefitBridge from the internet. 2. In the internet address bar, type:

1. Welcome to BenefitBridge. To access the BenefitBridge portal, login to BenefitBridge from the internet. 2. In the internet address bar, type: 1. Welcome to BenefitBridge. To access the BenefitBridge portal, login to BenefitBridge from the internet. 2. In the internet address bar, type: www.benefitbridge.com/egusd 1 1. If you are a returning

More information

Employee Online Enrollment User Guide

Employee Online Enrollment User Guide Employee Online Enrollment User Guide Welcome to Online Enrollment! In this guide, you will find information and step-by-step instructions on how to enroll in your benefits. Table of Contents Before you

More information

HELPFUL DEFINITIONS... 2 BENEFITS OVERVIEW... 3 ALLOWABLE BENEFIT ENROLLMENT PERIODS...

HELPFUL DEFINITIONS... 2 BENEFITS OVERVIEW... 3 ALLOWABLE BENEFIT ENROLLMENT PERIODS... Title: My Personal Information: 2017 Self Service Benefits User Guide Date Modified: 5/4/2017 Purpose: The purpose of this document is to assist new OHIO employees with benefits enrollment or existing

More information

Dependent Eligibility Verification

Dependent Eligibility Verification Dependent Eligibility Verification With medical plan costs on the rise, Ardent continues to look for ways to make sure our health plans run as effectively as possible. One way to do this is to make sure

More information

HELPFUL DEFINITIONS... 2 BENEFITS OVERVIEW... 3 ALLOWABLE BENEFIT ENROLLMENT PERIODS...

HELPFUL DEFINITIONS... 2 BENEFITS OVERVIEW... 3 ALLOWABLE BENEFIT ENROLLMENT PERIODS... Title: My Personal Information: Self Service Benefits User Guide Date Modified: 2/19/2019 Purpose: The purpose of this document is to assist new OHIO employees with benefits enrollment or existing OHIO

More information

Apply Online For Social Security Benefits

Apply Online For Social Security Benefits Apply Online For Social Security Benefits Apply Online For Social Security Benefits Why should I apply for benefits online? Applying for benefits online offers several advantages, among them: You apply

More information

Public Employees Benefits Program

Public Employees Benefits Program Public Employees Benefits Program Qualifying Life Status Events Updated August 12, 2015 901 South Stewart Street, Suite 1001 Carson City, NV 89701 775-684-7000. 800-326-5496 Fax: 775-684-7028 Email: mservices@peb.state.nv.us

More information

Group Administration Manual. For all group sizes Missouri and Wisconsin MUEENABS Rev. 9/12

Group Administration Manual. For all group sizes Missouri and Wisconsin MUEENABS Rev. 9/12 Group Administration Manual For all group sizes Missouri and Wisconsin 23631MUEENABS Rev. 9/12 Member services information for your convenience Health coverage inquiries Anthem Blue Cross and Blue Shield

More information

Open Enrollment November 1 23, 2016

Open Enrollment November 1 23, 2016 Open Enrollment November 1 23, 2016 All employees must make Medical, Dental and Vision elections for the new plan year beginning January 1, 2017, by going into the Open Enrollment (OE) portal in MyIIT.

More information

Open Enrollment User Guide

Open Enrollment User Guide Open Enrollment User Guide Open Enrollment is your once per year chance to make changes to your benefits, unless you experience a HIPAA Qualifying Life Event. Open Enrollment will run from Monday, October

More information

MyBenefits. Online Benefits Enrollment following a Qualifying Event

MyBenefits. Online Benefits Enrollment following a Qualifying Event MyBenefits Online Benefits Enrollment following a Qualifying Event This guide will help you navigate MyBenefits (mybenefits.nd.edu), the University s online benefits enrollment and change application.

More information

Health Care Plans A14742W. Health Care Plans 2009 Edition

Health Care Plans A14742W. Health Care Plans 2009 Edition Health Care Plans Summary Plan Description 2009 Edition/Union-Represented Employees IBCJA 721; IBEW 2295; IBPATA 36; IBT 578 and 952; UAW 864, 887, 952, 1519, and 1558; SMWIA 461 The summary plan description

More information

State of Florida Qualifying Status Change Event Matrix

State of Florida Qualifying Status Change Event Matrix A. Change in Enrollee s Legal Marital Status Marriage 1. Legally recognized marriage between two persons under any state or foreign law at the time the marriage was entered into by the parties. Common

More information

Coverage Effective Date as a Result of a Permitted Election Change Event

Coverage Effective Date as a Result of a Permitted Election Change Event LIFE INSURANCE EMPLOYER PROVIDED The life insurance plan provides term life insurance coverage (no cash value) that is payable in the event of an employee death, thus giving the family or beneficiary financial

More information

University of Michigan 2019 Benefits Enrollment Form For University of Michigan benefits eligible members.

University of Michigan 2019 Benefits Enrollment Form For University of Michigan benefits eligible members. WE University of Michigan 2019 Benefits Enrollment Form For University of Michigan benefits eligible members. 1. How to Use This Form You can use this form instead of Self Service > Benefits to elect your

More information

EMPLOYEE NAVIGATOR NEW HIRE BENEFIT INSTRUCTIONS 1

EMPLOYEE NAVIGATOR NEW HIRE BENEFIT INSTRUCTIONS 1 EMPLOYEE NAVIGATOR NEW HIRE BENEFIT INSTRUCTIONS 1 Go to: https://www.employeenavigator.com/! Login (upper right)! Register as New User! Fill in required Info (Company Identifier is SPS186) >Next! Create

More information

Qualifying Life Events

Qualifying Life Events 901 S. Stewart Street, Suite 1001 Carson City, NV 89701 Qualifying Life Events Completing Changes Due to a Qualifying Life Event Summary of Supporting Eligibility Documents Qualifying Life Events Quick

More information

LOS ANGELES POLICE RELIEF ASSOCIATION, INC. HEALTH CARE BENEFITS ELIGIBILITY BOOKLET FOR ACTIVE MEMBERS

LOS ANGELES POLICE RELIEF ASSOCIATION, INC. HEALTH CARE BENEFITS ELIGIBILITY BOOKLET FOR ACTIVE MEMBERS LOS ANGELES POLICE RELIEF ASSOCIATION, INC. HEALTH CARE BENEFITS ELIGIBILITY BOOKLET FOR ACTIVE MEMBERS Updated as of April 1, 2017 TABLE OF CONTENTS 1. INTRODUCTION... 1 2. ACTIVE MEMBER ELIGIBILITY...

More information

2016 Regions Benefits Enrollment FAQs

2016 Regions Benefits Enrollment FAQs 2016 Regions Benefits Enrollment FAQs Q: What happens if I don t enroll during the open enrollment period? A: If you don t enroll between November 2 nd and November 13th, you will NOT have coverage for

More information

*Name (Last, First, MI) Please Print *Social Security Number *Date of Birth *Gender *Relation

*Name (Last, First, MI) Please Print *Social Security Number *Date of Birth *Gender *Relation SGI-12 11/15 Dependent Eligibility Certification Form If you cover dependents under any State Group Insurance plan, you must certify their eligibility by completing this form before any changes to your

More information

MyOEBB Benefits New Hire Enrollment Guide

MyOEBB Benefits New Hire Enrollment Guide MyOEBB Benefits New Hire Enrollment Guide Once you enroll, no plan changes can be made until the next Open Enrollment period unless you experience a Qualified Status Change (QSC)*. *Please see your educational

More information

Quick Reference Guide: Open Enrollment

Quick Reference Guide: Open Enrollment Overview Open Enrollment at the University of Chicago will begin on November 1, 2018 and will end November 15, 2018. All new elections and changes made during this period will take effect January 1, 2019.

More information

Enrollment after the initial 31 day period is limited to the annual NUFlex enrollment or when a Permitted Election Change Event occurs.

Enrollment after the initial 31 day period is limited to the annual NUFlex enrollment or when a Permitted Election Change Event occurs. VOLUNTARY LIFE INSURANCE The life insurance plan provides term life insurance coverage (no cash value) that is payable in the event of an employee death, thus giving the family or beneficiary financial

More information

Retirement Handbook For members hired before July 1, 2011

Retirement Handbook For members hired before July 1, 2011 Retirement Handbook For members hired before July 1, 2011 Table of Contents General Information 1 Types of Retirement 3 Disability Retirements 6 Benefits 8 Death Benefits 11 The Retirement Process 13 GENERAL

More information

EXPRESS. Employee Guide

EXPRESS. Employee Guide EXPRESS EXPRESS Employee Guide Employee Guide Your Benefit Administration Self-Service Center Trustmark ------------------------------------------------------------------------------------------------------------

More information

Healthcare Participation Section MMC Draft NA

Healthcare Participation Section MMC Draft NA March 17, 2009 Healthcare Participation Section MMC Draft NA Note to Reviewers: No notes at this time Date May 1, 2009 Participating in Healthcare Benefits MMC Participating in Healthcare Benefits This

More information

Support Staff (AUPE) Benefits Enrolment New Hire

Support Staff (AUPE) Benefits Enrolment New Hire Support Staff (AUPE) Benefits Enrolment New Hire Reference Guide Purpose: Audience: Prerequisites: Related Documents This reference guide provides you with the steps to enrol in Support Staff (AUPE) group

More information

OPEN ENROLLMENT... 2 LINKS TO NEW BENEFITS OPTIONS & DESCRIPTIONS... 2 SYSTEM REQUIREMENTS...

OPEN ENROLLMENT... 2 LINKS TO NEW BENEFITS OPTIONS & DESCRIPTIONS... 2 SYSTEM REQUIREMENTS... Title: Oracle Advanced Benefits: Open Enrollment Date Modified: 4/5/2018 Purpose: The purpose of this document is to assist OHIO employees with Open Enrollment, the annual (mid-april early-may) opportunity

More information

Benefits Enrollment - Life Event Rules and Requirements. When is the change effective? Change is effective on the date of birth.

Benefits Enrollment - Life Event Rules and Requirements. When is the change effective? Change is effective on the date of birth. Benefits Enrollment - Life Event Rules and Requirements You can make changes to your medical plan, coverage level or election during the year if you qualify for a Special Enrollment under HIPAA (Health

More information

Benefits Handbook Date January 1, Personal Life Insurance Plan Marsh & McLennan Companies

Benefits Handbook Date January 1, Personal Life Insurance Plan Marsh & McLennan Companies Date January 1, 2013 Marsh & McLennan Companies Personal Life Insurance is Unum s Interest-Sensitive Whole Life Insurance policy which you may purchase through Marsh US Consumer, a Marsh & McLennan Company.

More information

Welcome to Employee Navigator your on-line benefits enrollment portal!

Welcome to Employee Navigator your on-line benefits enrollment portal! Welcome to Employee Navigator your on-line benefits enrollment portal! On this site you will enroll in the medical, dental, flexible spending, and voluntary term life insurance plans that best fit your

More information

Retirement Handbook For members hired on or after July 1, 2011

Retirement Handbook For members hired on or after July 1, 2011 Retirement Handbook For members hired on or after July 1, 2011 Table of Contents General Information 1 Types of Retirement 3 Disability Retirements 6 Benefits 8 Death Benefits 11 The Retirement Process

More information

EMPLOYEE BENEFITS MID-YEAR QUALIFYING EVENT CHANGES (Revised 12/8/2014)

EMPLOYEE BENEFITS MID-YEAR QUALIFYING EVENT CHANGES (Revised 12/8/2014) EMPLOYEE BENEFITS MID-YEAR QUALIFYING EVENT CHANGES (Revised 12/8/2014) The Change or Enrollment Form MUST be presented to the Insurance Department NO LATER THAN 30 DAYS after the qualifying event date.

More information

COBRA & USERRA (USERRA)

COBRA & USERRA (USERRA) COBRA & USERRA Under federal law, you and/or your dependents must be given the opportunity to continue health coverage when there is a qualifying event that would result in loss of coverage under the plan.

More information

Benefits Handbook Date September 1, Personal Life Insurance Plan Marsh & McLennan Companies

Benefits Handbook Date September 1, Personal Life Insurance Plan Marsh & McLennan Companies Date September 1, 2018 Marsh & McLennan Companies As of May 1, 2014, UNUM ceased writing the Personal Life Insurance product, therefore, the has been frozen effective May 1, 2014. No new enrollees will

More information

Special Enrollment Period

Special Enrollment Period December 14, 2017 Plan Year 2018 Special Enrollment Period Blue Cross and Blue Shield of Illinois (BCBSIL) Producer Training on Validation & Enrollment Processes for Non-Marketplace (Off Exchange) Policies

More information

BENEFITS ENROLLMENT GUIDE FOR NEW HIRES

BENEFITS ENROLLMENT GUIDE FOR NEW HIRES BENEFITS ENROLLMENT GUIDE FOR NEW HIRES 2014 These instructions will help you navigate through the enrollment process in making your benefit elections as a new employee. RESOURCES If you have additional

More information

BENEFIT ELIGIBILITY. Employee. Dependent

BENEFIT ELIGIBILITY. Employee. Dependent BENEFIT ELIGIBILITY BENEFIT ELIGIBILITY Benefits under the CHEIBA Trust Plans are available to Eligible Employees and Dependents of the State colleges, universities and institutions of higher education

More information

( ) M-F 8 AM 6PM

( ) M-F 8 AM 6PM To begin your registration, visit https://my.adp.com. If you are a First Time User, click Register Now you will need the following registration code: SoGAMedCtr-ess If you have already registered, enter

More information

New Hire Enrollment Instructions:

New Hire Enrollment Instructions: New Hire Enrollment Instructions: There are 13 benefits you must take action on before you can submit & finish URGENT: You MUST submit your pre-enrollment within 30 days or less from your Hire Date Welcome

More information

Your Benefits Resources 101

Your Benefits Resources 101 Your Benefits Resources 101 How to Enroll Enrolling means choosing the right benefits for you and your family. With Your Benefits Resources, it s easy to find what fits. Use this to explore and enroll

More information

IMPORTANT INFORMATION ABOUT YOUR COBRA CONTINUATION COVERAGE RIGHTS University of Michigan Group Health Plan

IMPORTANT INFORMATION ABOUT YOUR COBRA CONTINUATION COVERAGE RIGHTS University of Michigan Group Health Plan IMPORTANT INFORMATION ABOUT YOUR COBRA CONTINUATION COVERAGE RIGHTS University of Michigan Group Health Plan What is COBRA coverage? COBRA coverage is a continuation of Plan coverage required under Federal

More information

OVERVIEW ACTIVE EMPLOYEE ELIGIBILITY POLICY

OVERVIEW ACTIVE EMPLOYEE ELIGIBILITY POLICY OVERVIEW ACTIVE EMPLOYEE ELIGIBILITY POLICY This document is an overview of the eligibility policy effective October 1, 2018. If you would like a complete copy of this policy please contact your district

More information

SAMPLE CAFETERIA PLAN

SAMPLE CAFETERIA PLAN HR COMPLIANCE CENTER Cafeteria plans are governed by Internal Revenue Code 125 requiring employees to make irrevocable elections before the start of the plan year. Midyear changes are prohibited except

More information

Enrolling as a New Employee or Newly Eligible for Benefits Employee

Enrolling as a New Employee or Newly Eligible for Benefits Employee Enrolling as a New Employee or Newly Eligible for Benefits Employee If enrolling dependents, you will need to provide the following information and documentation: Marriage Certificate or Oregon Certificate

More information

OPEN ENROLLMENT. Public School Employees (PSE)

OPEN ENROLLMENT. Public School Employees (PSE) 2019 OPEN ENROLLMENT Public School Employees (PSE) What s Inside Open Enrollment... 3 Enrolling Online... 5 Health Insurance 101... 6 Health Plans... 7 Securian...13 HSA...14 Links to Forms...16 Contacts

More information

MARRIAGE GAIN A SPOUSE OR DOMESTIC PARTNER

MARRIAGE GAIN A SPOUSE OR DOMESTIC PARTNER MARRIAGE GAIN A SPOUSE OR DOMESTIC PARTNER SCOPE: This is a US Employee Direct Access procedure. An employee should perform this procedure when they get married. IMPORTANT: The marriage should be entered

More information

Department of Employee Trust Funds

Department of Employee Trust Funds Department of Employee Trust Funds GROUP HEALTH INSURANCE APPLICATION/CHANGE FORM State of Wisconsin Employees and Annuitants Wisconsin Public Employees and Annuitants UW Graduate Assistants, Employees

More information

MyBenefits Open Enrollment User Guide

MyBenefits Open Enrollment User Guide MyBenefits Open Enrollment User Guide This guide will help you navigate MyBenefits, the University s online benefits enrollment application. All benefit-eligible faculty and staff must actively enroll

More information

2016 Benefits Enrollment Form

2016 Benefits Enrollment Form 2016 Benefits Enrollment Form Need assistance in completing this form? Call the SWN Benefits Center Helpline 855.796.3637 Complete and submit this form and required documentation to houston.gbs.bac.tasks@ajg.com

More information

OnlinEnroll Employee Self Service for CSS Dynamac, Inc.

OnlinEnroll Employee Self Service for CSS Dynamac, Inc. OnlinEnroll Employee Self Service for CSS Dynamac, Inc. New Hire and Open Enrollment pages 2-6 Year-round Access and Qualifying Events page 7 OnlinEnroll is a tool which allows you to directly access and

More information

Understanding Eligibility and Special Enrollment

Understanding Eligibility and Special Enrollment Understanding and Special Enrollment Am I eligible for? In order to qualify for health insurance with Sharp Health Plan s individual and family plans, you must: Not be enrolled with Medicare Be a U.S.

More information

CABS New Employee Benefits Enrollment Guide. Coventry Corporate Benefits

CABS New Employee Benefits Enrollment Guide. Coventry Corporate Benefits CABS New Employee Benefits Enrollment Guide Coventry Corporate Benefits Table of Contents Overview Initial Login Screen Welcome Screen Personal Information screen (Adding Dependents and Beneficiaries)

More information

Changes initiated or documentation received after 30 days will not be accepted and changes cannot be made until the next open enrollment period.

Changes initiated or documentation received after 30 days will not be accepted and changes cannot be made until the next open enrollment period. Birth of a Child Follow the instructions to add your newborn to your CSU insurance. You are permitted to make mid-year election changes within 30 days of an IRS approved qualifying event. It is necessary

More information

People First User Guide for the Benefits Enrollment Process

People First User Guide for the Benefits Enrollment Process People First User Guide for the Benefits Enrollment Process Table of Contents Change My Benefits Overview... 2 Introduction... 2 Getting Started... 2 Change My Benefits... 4 Introduction... 4 Getting Started...

More information

Handbook. TreeHouse Foods, Inc. Health and Welfare Benefits Plan. Non-union Employees. Effective January 1, 2017

Handbook. TreeHouse Foods, Inc. Health and Welfare Benefits Plan. Non-union Employees. Effective January 1, 2017 Handbook TreeHouse Foods, Inc. Health and Welfare Benefits Plan Non-union Employees Effective January 1, 2017 This document, together with each of the benefits booklets and insurance contracts of coverage,

More information

FundsAtWork Umbrella Funds and stand-alone insurance schemes* beneficiary nomination form

FundsAtWork Umbrella Funds and stand-alone insurance schemes* beneficiary nomination form FundsAtWork Umbrella Funds and stand-alone insurance schemes* beneficiary nomination form Please complete the fields provided. Use the tab key to move from one field to the next. *Stand-alone insurance

More information

MyBenefits. Online Benefits Enrollment for New Employees

MyBenefits. Online Benefits Enrollment for New Employees MyBenefits Online Benefits Enrollment for New Employees Welcome to the University of Notre Dame! This guide will help you navigate MyBenefits (mybenefits.nd.edu), the University s online benefits enrollment

More information

SUMMARY PLAN DESCRIPTION for the Verso Corporation Health and Welfare Benefit Plan

SUMMARY PLAN DESCRIPTION for the Verso Corporation Health and Welfare Benefit Plan SUMMARY PLAN DESCRIPTION for the Verso Corporation Health and Welfare Benefit Plan Represented Employees 2018 This document, together with the benefit booklets listed in the section entitled Benefit Programs

More information

Benefits Handbook Date May 1, Personal Accident Insurance Plan Marsh & McLennan Companies

Benefits Handbook Date May 1, Personal Accident Insurance Plan Marsh & McLennan Companies Date May 1, 2011 Marsh & McLennan Companies The provides a benefit to someone you name as your BENEFICIARY if you die in an accident, or to you if you suffer DISMEMBERMENT as a result of an accident. Additional

More information

SUPPLEMENTAL ACCIDENT/ DISABILITY INSURANCE ELECTION INFORMATION

SUPPLEMENTAL ACCIDENT/ DISABILITY INSURANCE ELECTION INFORMATION SUPPLEMENTAL ACCIDENT/ DISABILITY INSURANCE ELECTION INFORMATION Save paper. Save a step. Save time. Instead of using this election form, make changes online at https://peoplefirst.myflorida.com. Learn

More information

Completing Open Enrollment PeopleSoft HRMS 9.2 Open Enrollment Date Created: 11/7/13 Date Updated: 10/03/18

Completing Open Enrollment PeopleSoft HRMS 9.2 Open Enrollment Date Created: 11/7/13 Date Updated: 10/03/18 Description: Accessing the Open Enrollment forms allow you to verify, edit, and submit your elections for the new enrollment period. Prerequisites: PeopleSoft credentials are assigned after CEO HR has

More information

Administrator Checklist

Administrator Checklist Administrator Guide Administrator Checklist For your convenience, here s a list of things health plan administrators are responsible for: Letting employees know if they re eligible to enroll in a timely

More information

CHECK ONE BOX: NEW HIRE/ NEW ENROLLEE CHANGING COVERAGE COVERAGE EFFECTIVE DATE: Employee Information ADDRESS: HOME PHONE ( ) -

CHECK ONE BOX: NEW HIRE/ NEW ENROLLEE CHANGING COVERAGE COVERAGE EFFECTIVE DATE: Employee Information ADDRESS: HOME PHONE ( ) - 2017 Medical and Vision/Dental Insurance CHECK ONE BOX: NEW HIRE/ NEW ENROLLEE CHANGING COVERAGE COVERAGE EFFECTIVE DATE: Employee NAME: Last First Middle EMPLOYEE #: YOUR EMPLOYEE # CAN BE FOUND ON THE

More information

EMPLOYEE USER GUIDE 10/03/ /27/2017

EMPLOYEE USER GUIDE 10/03/ /27/2017 EMPLOYEE USER GUIDE Open Enrollment 2018 10/03/2017 10/27/2017 browardschools.com/benefits TABLE OF CONTENTS PAGE # EMPLOYEE CHECKLIST 1 OPT-OUT PROCESS... 2 LIFE INSURANCE.. 3 DOMESTIC PARTNER ENROLLMENT

More information

Fordham University Health and Welfare Plan

Fordham University Health and Welfare Plan Fordham University Health and Welfare Plan SUMMARY PLAN DESCRIPTION Effective January 1, 2016 Contents INTRODUCTION... 1 ELIGIBILITY... 2 Employee Eligibility... 2 Individuals Not Eligible for Benefits...

More information

STARTING YOUR JOURNEY

STARTING YOUR JOURNEY STARTING YOUR JOURNEY No matter where you are on your journey at Houston Methodist, enrolling in your benefits is an important step. This Benefits Guide can help you evaluate your benefits and make decisions

More information

GENERAL NOTICE OF CONTINUATION COVERAGE RIGHTS UNDER COBRA

GENERAL NOTICE OF CONTINUATION COVERAGE RIGHTS UNDER COBRA GENERAL NOTICE OF CONTINUATION COVERAGE RIGHTS UNDER COBRA You are receiving this notice because you recently became covered under American Airlines Group Health Plan (the Plan). This notice contains important

More information

ONLINE BENEFITS ENROLLMENT USER GUIDE

ONLINE BENEFITS ENROLLMENT USER GUIDE ONLINE BENEFITS ENROLLMENT USER GUIDE TABLE OF CONTENTS Online Benfits Enrollment Getting Started... 3 Step 1: Logging in to the Online Enrollment portal... 3 Step 2: Selecting Your VMware Benefits...

More information

Caliber Holdings Corporation Employee Benefits Plan

Caliber Holdings Corporation Employee Benefits Plan Caliber Holdings Corporation Employee Benefits Plan SUMMARY PLAN DESCRIPTION Effective April 1, 2016 Contents INTRODUCTION... 1 ELIGIBILITY... 3 Eligibility for Benefits... 3 Individuals not eligible for

More information

2017 Lubbock County Enrollment Guide

2017 Lubbock County Enrollment Guide 2017 Lubbock County Enrollment Guide Choose Well Plan Well Live Well WELCOME This guide is designed to help you understand your benefits. Review this material carefully before making your enrollment decisions.

More information

» 2009 Benefits Summary. for U.S. Full-Time Hourly & Salaried Associates

» 2009 Benefits Summary. for U.S. Full-Time Hourly & Salaried Associates » 2009 Benefits Summary for U.S. Full-Time Hourly & Salaried Associates What s inside 1 Life Events 12 Eligibility and Enrollment 27 Benefits for Same-sex Domestic Partners 34 Medical 114 California Medical

More information

Minnesota Life Basic & Supplemental Term Life

Minnesota Life Basic & Supplemental Term Life Minnesota Life Basic & Supplemental Term Life Pending underwriting approval BASIC EMPLOYEE LIFE INSURANCE This insurance is payable for death from any cause to any person you name as benefi ciary. SUPPLEMENTAL

More information

Group Insurance Eligibility Factsheet for Employees and Eligible Family Members

Group Insurance Eligibility Factsheet for Employees and Eligible Family Members UNIVERSITY OF CALIFORNIA Group Insurance Eligibility Factsheet for Employees and Eligible Family Members This factsheet describes UC s general rules about: employee eligibility for health and welfare benefits

More information

BREMEN PUBLIC SCHOOLS HEALTH AND WELLNESS PROGRAMS OCTOBER 19, 2017

BREMEN PUBLIC SCHOOLS HEALTH AND WELLNESS PROGRAMS OCTOBER 19, 2017 BREMEN PUBLIC SCHOOLS HEALTH AND WELLNESS PROGRAMS OCTOBER 19, 2017 ENROLLMENT OPPORTUNITIES 1. Hire Date A new hire has 31 days from the first working day to enroll. 2. Open Enrollment All full-time employees

More information

POLICY AND REGULATIONS MANUAL HEALTH AND RELATED BENEFITS

POLICY AND REGULATIONS MANUAL HEALTH AND RELATED BENEFITS Page Number: 1 of 24 TITLE: HEALTH AND RELATED BENEFITS PURPOSE: To provide an overview of the health and related benefits offered to Benefit Eligible Employees, Benefit Eligible Retirees, and their Benefit

More information

New York Guide to List Billing WELCOME TO DEARBORN NATIONAL. Life Insurance Company of New York

New York Guide to List Billing WELCOME TO DEARBORN NATIONAL. Life Insurance Company of New York www.dearbornnational.com WELCOME TO DEARBORN NATIONAL UNDERWRITTEN BY DEARBORN NATIONAL LIFE INSURANCE COMPANY OF NEW YORK New York Guide to List Billing Life Insurance Company of New York Products and

More information

Group Administrator Guide administering your regence health plans

Group Administrator Guide administering your regence health plans Regence BlueCross BlueShield of Utah is an Independent Licensee of the Blue Cross and Blue Shield Association Group Administrator Guide administering your regence health plans Group Administrator s Guide

More information

Benefit Plan and Trust

Benefit Plan and Trust 2 01 7 HY-VEE AN D A F F I LI ATE S Benefit Plan and Trust QUICK REFERENCE GUIDE Please keep this booklet and use it during the year to answer your benefit questions. Benefits Overview The Hy-Vee and Affiliates

More information

The benefits you elect as a new hire or during Open Enrollment remain in effect all

The benefits you elect as a new hire or during Open Enrollment remain in effect all ADDITIONAL LINKS: www.benefits.hcr-manorcare.com Know How Life & Work Events Impact Your Benefits QUICK REFERENCE MyBenefits Online: www.benefits.hcr-manorcare.com Businessolver COBRA Call Center: 1.877.547.6257

More information

True Potential Investor Overdue Payments. Contents

True Potential Investor Overdue Payments. Contents OVERDUE PAYMENTS Contents Overdue Payments 3 Pay Reference Periods 3 Pay Reference Period Start Dates - Examples: 3 Overdue Payments page 4 View Members 5 Upload Contribution 5 The Contributions Template

More information

Kern County HR County Administrative Office

Kern County HR County Administrative Office Kern County HR County Administrative Office 1115 Truxtun Avenue, 1st Floor, Bakersfield, CA 93301 Telephone (661) 868-3182 Fax (661) 868-3110 Ryan Alsop County Administrative Officer Devin Brown Chief

More information

2017 Annual Enrollment Guide

2017 Annual Enrollment Guide 2017 Annual Enrollment Guide Get Started Today Annual Enrollment is your opportunity to make decisions about your health and insurance coverage for next year. You can get started today by: Learning about

More information

Benefit What you need to know What you need to review and/or decide How to take action

Benefit What you need to know What you need to review and/or decide How to take action retirement checklist Thinking about retirement? Retirement is a major milestone worth celebrating. You ve dedicated your time to Ford and played a big part in its success. In turn, Ford offers a variety

More information

State of Florida Qualifying Status Change Event Matrix

State of Florida Qualifying Status Change Event Matrix A. Change in Enrollee s Legal Marital Status Marriage 1. Legally recognized marriage between two persons under any state or foreign law at the time the marriage was entered into by the parties. Common

More information

Class No, Classification, or Plan Design. Enrollment Information

Class No, Classification, or Plan Design. Enrollment Information OSU Graduate Assistant Health Insurance ENROLLMENT APPLICATION Group Policy. G0021007 Subgroup. P001 Active P002 COBRA Class, Classification, or Plan Design PO Box 7068 Springfield, OR 97475 541.684.5583

More information

IMPORTANT ACTION REQUIRED: Dependent Eligibility Verification Period Has Arrived

IMPORTANT ACTION REQUIRED: Dependent Eligibility Verification Period Has Arrived q, q, A111 i,"iu DEPEDET VERIFICATIO CETER P.O. BOX 1415 LICOLSHIRE, IL 669-1415 Return Service Requested 12639-2247-6 IIAEC?182198 4-1-217 I 4/1/217 TIME SESITIVE MA TE RIALS ECLOSED IMPORTAT ACTIO REQUIRED:

More information

2017 Benefits Summary Plan Description. For Campus Retirees

2017 Benefits Summary Plan Description. For Campus Retirees 2017 Benefits Summary Plan Description For Campus Retirees ii 2017 BENEFITS SUMMARY PLAN DESCRIPTION FOR CAMPUS RETIREES TABLE OF CONTENTS CALTECH RETIREE HEALTH AND LIFE BENEFITS PROGRAM... 1 ABOUT THIS

More information

Divorce/Legal Separation/Civil Union or Domestic Partner Dissolution

Divorce/Legal Separation/Civil Union or Domestic Partner Dissolution Divorce/Legal Separation/Civil Union or Domestic Partner Dissolution Follow the instructions to add your newborn to your CSU insurance. You are permitted to make mid-year election changes within 30 days

More information

Premium-Only Plan (POP)

Premium-Only Plan (POP) FREQUENTLY ASKED QUESTIONS BY ADJUNCT FACULTY REGARDING ACCESSING THE LACCD HEALTH BENEFITS PROGRAM An Adjunct or Limited-Term faculty member employed with the District may participate in the LACCD Health

More information